The relationship between coronary collateral circulation and contrast induced nephropathy in patients with non-ST elevation myocardial infarction

Abstract

BACKGROUND: Contrast induced nephropathy (CM) is defined as a temporary renal failure follov,ing the administration of radiocontrast agent during the coronary angiography. It is associated with increases in morbidity and mortality in patients with acute coronary syndrome (ACS). The aim of this study is to evaluate the relationship between CCC and CIN in patients with non-ST elevation myocardial infarction (NSTEMI).

METHODS: CIN was diagnosed with a 25% or 0.5 g/dL increase in blood creatinine levels after 48-72 hours following the administration of contrast agent during the coronary angiography. For the purpose of evaluating the coronary collaterals, the Rentmp classification was used.

RESULTS: A total 269 patients were participated in the study population (55 in CIN(+) group, 214 in CIN(-) group). The blood creatinine levels were significantly higher in the CIN(+) group on the 48-72 hours following the coronary angiography. In the studied population, 70 out of 269 patients had a good CCC according the Rentrop classification (64 patients [30%] in the CIN(-) group, six patients [16%] in the CIN(+) group). The frequency of the well-developed coronary collaterals were significantly higher in the CIN(-) group (P<0.001). The logistic regression analysis indicated that the presence of poor-developed coronary collaterals is an independent risk factor for the development of CIN in our study population.

CONCLUSIONS: The presence of well-developed coronary collaterals was associated with decreased frequency of CIN in patients with NSTEMI on the 48-72 hours following the coronary angiography.